Hubungan Praktik Pemberian ASI dan MP-ASI dengan Status Gizi Baduta di Kabupaten Cirebon

Abstract

Praktik pemberian ASI dan MP-ASI pada 1000 Hari Pertama Kelahiran (HPK) memiliki peran penting terhadap pertumbuhan, perkembangan, dan kesehatan anak. Berdasarkan data Studi Status Gizi Indonesia (SSGI), prevalensi kurus (wasting) pada Provinsi Jawa Barat sebesar 5,3% dan prevalensi wasting di Kabupaten Cirebon cukup tinggi dan menempati urutan kedua setelah Kabupaten Indramayu yaitu 10,7% (SSGI 2021). Anak yang wasting sangat berisiko mengalami penyakit infeksi dikarenakan tidak terpenuhinya kebutuhan zat gizi dan jika permasalahan wasting tidak segera ditangani maka konsekuensinya akan timbul permasalahan lain seperti meningkatkan risiko stunting, gangguan perkembangan kognitif, dan berisiko terkena penyakit tidak menular di masa dewasa. Anak perlu diberikan ASI eksklusif dan MP-ASI yang tepat untuk menunjang kesehatan anak. Indikator yang digunakan dalam melihat praktik pemberian ASI dan MP-ASI adalah Infant and Young Child Feeding Practices yang diterbitkan oleh WHO (2021). Tujuan dari penelitian ini adalah menganalisis hubungan praktik pemberian ASI dan MP-ASI dengan status gizi baduta di Kabupaten Cirebon. Penelitian ini menggunakan data sekunder dengan desain cross-sectional yang diperoleh dari penelitian yang berjudul “Evaluasi Efektivitas Posyandu dalam Penanganan dan Pencegahan Stunting di Kabupaten Cirebon” (Riyadi et al. 2020). Penelitian tersebut dilaksanakan pada bulan Juni sampai November 2020 di Kecamatan Suranenggala, Kabupaten Cirebon. Subjek penelitian ini berjumlah 44 baduta. Data yang digunakan dalam penelitian ini meliputi: 1) Karakteristik responden (usia, pendidikan, status bekerja, besar keluarga, dan pendapatan keluarga); 2) Karakteristik subjek (usia, jenis kelamin, berat badan dan panjang badan lahir; 3) Status gizi baduta; dan 4) praktik pemberian ASI dan MP-ASI yang meliputi inisiasi menyusu dini (IMD), pemberian ASI, waktu pengenalan MP-ASI, minimum diet diversity (MDD), minimum meal frequency (MAF), minimum acceptable diet (MAD), dan konsumsi pangan sumber zat besi. Analisis data yang dilakukan adalah uji univariat, bivariat, dan multivariat. Analisis bivariat menggunakan uji korelasi Spearman dan analisis multivariat menggunakan uji Regresi Logistik. Hasil penelitian menunjukkan bahwa usia responden pada penelitian ini ratarata 32±5,0 tahun dan masih dalam rentang Wanita Usia Subur (WUS), pendidikan ibu sebagian besar (63,6%) Sekolah Dasar dan Sekolah Menengah Pertama. Sebagian besar responden (86,4%) berprofesi sebagai ibu rumah tangga, dan memiliki pendapatan keluarga rata-rata sebesar RP 2.342.824,6±1.963.391,0. Pendapatan keluarga merupakan faktor yang berperan pada kuantitas dan kualitas makanan dalam sebuah keluarga. Usia subjek berada pada rentang enam (6) – 23 bulan dengan rata-rata usia 14,4±4,6 bulan. Sebagian besar (54,5%) berjenis kelamin laki-laki, memiliki berat badan lahir rata-rata 3.101±445,8 gram, dan panjang badan lahir rata-rata sebesar 47,9±4,1 cm. Sebagian besar subjek (70,5%) mendapatkan inisiasi menyusu dini (IMD), akan tetapi yang memberikan ASI eksklusif hanya 13,6%. Sebanyak 81,8% responden memperkenalkan MP-ASI pada subjek sejak usia kurang dari 6 bulan (77,3%) dan sebagian besar (70,4%) minimum acceptable diet telah terpenuhi. Tidak terdapat hubungan yang signifikan (p>0,05) antara karakteristik responden (usia, pendidikan, status bekerja, besar keluarga, dan pendapatan keluarga) terhadap pemberian ASI dan MP-ASI (IMD, pemberian ASI, waktu pengenalan MP-ASI, MDD, MMF, MAD, konsumsi pangan sumber zat besi). Tidak terdapat hubungan yang signifikan (p>0,05) antara pemberian ASI dan MPASI (IMD, pemberian ASI, waktu pengenalan MP-ASI, MDD, MMF, MAD, konsumsi pangan sumber zat besi) dengan status gizi baduta. Berdasarkan hasil uji regresi logistik didapatkan bahwa variabel praktik ASI dan MP-ASI tidak memengaruhi status gizi baduta. Namun penerapan MMF dan konsumsi pangan sumber zat besi yang sesuai rekomendasi cenderung memiliki status gizi yang lebih baik.

The first two (2) years feeding practices a crucial role in the growth, development, and health of children. According to data from Study of Nutritional Status in Indonesia 2021, wasting in an infant under two years old between zero (0) and 23 months is 5.3% in West Java Province. Cirebon Regency has a high prevalence of wasting, the second rank after Indramayu Regency at 10.7%. Because their nutritional needs are not met, wasting infants are at a high risk of contracting infectious diseases. If the problem of wasting is not addressed immediately that the other issues will arise, including an increased risk of stunting, impaired cognitive development, and the risk of developing non-communicable diseases in adulthood. Exclusive breastfeeding and complementary feeding practices that are done correctly can help an infant's health. In this research to assess breastfeeding and complementary feeding practices used Infant and Young Child Feeding Practices from WHO. Therefore, this study aimed to analyze the relationship between breastfeeding and complementary feeding practices and the nutritional status of under two years old children in Cirebon District. This study draws on secondary data titled "Posyandu Effectiveness Evaluation of Handling and Preventing Stunting in Cirebon Regency" (Riyadi et al. 2020). Cross-Sectional Study were used as the research design. The study took place in Suranenggala Subdistrict, Cirebon District, from June to November 2020. The participants in this study were 44 under two (2) years old children. The data includes 1) Respondent characteristics (age, education, occupation status, family size, and family income); 2) Subject characteristics (age, gender, birth weight, and length); 3) Nutritional status of under two years old children; and 4) Breastfeeding and complementary feeding practices, which include early initiation of breastfeeding, duration of breastfeeding, the timing of complementary feeding introduction, minimum diet diversity (MDD), minimum meal frequency (MMF), minimum acceptable diet (MAD), and iron-rich food consumption. Univariate, bivariate, and multivariate tests were used to analyze the data. Bivariate analysis used the Spearman correlation and multivariate analysis used Logistic Regression. According to the findings, the average age of the respondents in this study is 32±5,0 years, which is still within the range of women of reproductive age, and the majority of the mothers' education (63.6%) is primary school and junior high school. The average of respondent’s occupation (86,4%) are housewives and the average family income is Rp 2,342,824.6±1,963,391,0. Family income influences the quantity and quality of food consumed by a family. Subjects ranged from 6 (six) to 23 months, with an average age of 14±4,6 months. The majority (54.5%) were male, with an average birth weight of 3,101±445,8 grams and the average of birth is 47,9±4,1 cm. Early initiation of breastfeeding was given to the majority of the subjects (70.5%), but only eight subjects gave exclusive breastfeeding (13.6%). Thirty-six respondents (81.8%) have introduced complementary feeding to their infant under six months, with 34 respondents introducing complementary feeding to an children under two years old (77.3%). In addition, the majority of the minimum acceptable diet (70.4%) was met. Breastfeeding and complementary feeding (early initiation of breastfeeding, duration of breastfeeding, time of introduction of complementary feeding, MDD, MMF, MAD, consumption of foods containing iron) had no significant relationship (p>0.05) with respondent characteristics (age, education, occupation, family size, and family income). There was no significant relationship (p>0.05) between the nutritional status of under two years old children and breastfeeding and complementary feeding (early initiation of breastfeeding, duration of breastfeeding, time of introduction of complementary feeding, MDD, MMF, MAD, consumption of foods containing iron). The results of the logistic regression test revealed that breastfeeding and complementary feeding did not affect subject’s nutritional status. However, MMF and iron-rich food consumption according to recommendation indicated better nutritional status of subject.